Do rural populations experience greater worry and fatalism about cancer?

07 Mar 2019

People living in rural areas are more likely to have ambiguous beliefs and fears about getting cancer, as well as more fatalistic viewpoints than urban dwellers, reports a research team from Mayo Clinic.

The clinic's catchment area includes 29 counties in five states with multiple rural areas.

The team conducted a population-based survey of randomly selected households across the three regions of the Mayo Clinic Cancer Center catchment area, receiving 1,157 completed responses.

"Survey respondents who live in the rural areas were more likely to agree with statements such as: 'It seems like everything causes cancer' or 'There is not much you can do to lower your chances of getting cancer' and 'There are so many different recommendations about preventing cancer, it's hard to know which ones to follow,'" explained Kristin J. Harden, M.P.H., a health services researcher at Mayo Clinic and the study's lead author. "They were also more likely to respond 'extremely' to the question: 'How worried are you about getting cancer?'"

Even though the team controlled for social and demographic variables, such as education, race and ethnicity, and health insurance status; they found that in general, people living in rural areas preferred not to know what their risk of developing cancer was.

In this instance at least, a lack of knowledge could be deadly.

"Having these kinds of pessimistic beliefs towards cancer prevention may discourage participation in cancer prevention and screening, which could contribute to health disparities," said Harden.

Recent reports indicate that both the incidence rates of cancer, as well as cancer-related deaths, are decreasing in the U.S.

However, in rural areas, observed declines are slower.

In fact, Harden mentioned, "This is particularly true for cancers that can be prevented through behaviour change, such as stopping smoking or participating in evidence-based cancer screenings such as colonoscopy. Public health researchers and health care professionals working in rural areas need to understand these attitudes, as well as the variability across the different communities they work in."

"Interventions that work in one community may not work in another. Therefore, professionals developing potential interventions should do so in collaboration with community members to ensure alignment with individual community needs and values," Harden also added.

The research team hopes to expand on these findings and to collaborate with rural community members to help better understand the findings and collect ideas that could lead to customised interventions for different communities.

"This research is directly responsive to NCI priorities, both with its focus on catchment area and on rural populations," said study senior author Lila Finney Rutten. "We expect these findings to inform our continued research in Mayo Clinic Cancer Center, as well as to improve our ability to better engage with and care for our rural populations."

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